DIABETES AWARENESS

People with diabetes need to be vigilant about the health of their feet because they face a higher risk of developing foot problems causing serious complications.

“Peripheral neuropathy” is the medical term for the nerve damage that affects so me people with diabetes, making them less likely to feel a cut or blister on their feet. They are also more prone to poor blood circulation to the legs and feet, so their foot injuries do not heal as quickly.

These conditions mean that foot wounds in these patients can lead to ulcers and infection, and, in the most serious cases, to amputation. Diabetes contributes to 70 per cent of all non-traumatic leg and foot amputations, according to Diabetes Canada.

People with diabetes can take steps to protect themselves from significant foot problems. They can also seek professional care and support from a foot care specialist, such as a Canadian certified pedorthist – C. Ped (C) an expert in foot orthotic and orthopedic footwear, and in assessment of lower-limb anatomy, and muscle and joint function.

“We see a large volume of patients with diabetes in our clinic,” says Kevin Fraser, C. Ped (C), and team lead, pedorthics, at the Sunnybrook Centre for Independent Living in Toronto.

“With diabetes, due to lost sensation and reduced circulation, a simple blister can quickly worsen and give rise to serious infection. By assessing a patient’s specific risks and providing basic foot care, we are trying to prevent significant complications.”

Certified pedorthists look for signs of potential trouble and guide patients to monitor their foot health daily, including by using a mirror to view the bottoms of their feet.

“Educating the patient is an important part of treatment,” explains Mr. Fraser. “We help them to understand the risk factors and what to look for when visually examining their feet.”

Areas of concern might be a developing callous, or an area where the skin has hardened or become red because of pressure or rubbing from their shoes or seams in their socks.”

Certified pedorthists also help individuals with diabetes by ensuring they have properly fitting footwear and, when needed, custom-made foot orthotics.

“The goal of the pedorthist is to address high-pressure areas in the footwear, and the easiest solution is often a custom-made foot orthotic,” says Peter Morcom, C. Ped (C), and president of the Pedorthic Association of Canada.

“By putting contact in the medial arch or other areas of the foot, and using cut-outs underneath the area of high pressure, we can help ensure that callouses or blisters start healing before they become serious,” says Mr. Morcom.

“And we can design orthotics with special foam materials that are more accommodative for a diabetic foot, and top covers that are less abrasive for people who have diabetes.”

A person with diabetes may not need an orthotic, he explains, but simply footwear that fits correctly.

“When shoes are too narrow or short, they can cause small abrasions that will lead to bigger problems. Getting your foot checked and measured properly and fitted into an appropriate shoe can make a big difference for someone with diabetes.”

Prevention and raising awareness of the risk for people with diabetes are high priorities, says Mr. Morcom.

“We encourage individuals who are living with diabetes to visit their pedorthist before something serious develops so they can work together to protect their foot health.”

Educating the patient is an important part of treatment. We help them to understand the risk factors and what to look for when visually examining their feet.